How to protect your child in the face of an epidemic?

When the story of a Qatari man flown to the UK with a Sars like virus broke, I avoided discussing it with anyone non-medical.  Why?  Not enough information was initially given and sometimes a little knowledge is dangerous.  And sometimes talking about it without full information leads to worry followed by panic.

As the reports surfaced, it was a relief to find that this new Coronavirus, pronounced Corona like the beer, is not easily transmissible.  And in both cases, the patients had been in Saudi Arabia.

But what is a parent to do if this were easily transmissible? Keep their kids home from school? Fly back to their home countries?  NO.

This particular virus is spread through respiratory droplets (again remember it is not easily transmissible). The best thing to do to keep your child (and you!) from getting these viruses is, yes you guessed it:  PREVENTION.  There are two ways to prevent it.  The first is to prevent transmission and the second is to prevent the virus from going to a full-blown illness or prevent progression by maintaining your immunity.

You may know the rules for preventing transmission but here they are just in case:


  • Cover your mouth when you cough

  • Wash your hands before you eat, prepare food and upon entering your home after being out.

  • Keep your hands away from your mouth and nose.


Even more important than these 3 rules above is to NOT send your child to school with a fever when they have an illness: viral or otherwise. A child should be fever free for 24 hours before returning to school.  I know, the moms who work might crucify me as it is an inconvenience to have to miss work but this is really important in preventing transmission. No, you may not pre-medicate with paracetamol or ibuprofen to lower your child’s fever and then send them to school.

You may ask but how do you ensure my children’s immune system is functioning at its finest?  You might be surprised to learn this but:


Unfortunately proper nutrition does not include: Mc Donald’s, sodas and chips. Too little emphasis is placed on the value of nutrition.  Several weeks ago while at a medical conference in Los Angeles, I was introduced to the term SAD: Standard American Diet.  Basically the standard “crappy” diet many kids eat: think processed foods, which are generally high in transaturated fatty acids.  While this term may not apply to expats, I think we could easily substitute: Children’s for American and get Standard Children’s Diet which would apply to a great majority of children across the globe aside from the 3rd world.


“The focus should be on your child’s nutrition to prevent illness.”


As an aside the American food pyramid is wrong with grains so heavily weighted on the bottom.  The pyramid needs to be flipped upside down placing grains at the top i.e. allowing for lower intake of grains while emphasizing fruits, vegetables, healthy fats and protein.

That is right healthy fats.  One serving of nuts or seeds per day will do the trick.  A serving is a handful, no more. Fruits and vegetables are important because they contain phytonutrients, which not only form the pigments in produce but also perform as highly efficient antioxidants in the body.

Experiment with vegetables to find ones your child likes.  Remember, sometimes a new food needs to be introduced multiple times before a child will eat it.  Your child’s palette will change to include more foods as they age as well.  Another tip is to teach your child to eat in a rainbow: the more colors on their plate the better. If they are still not great vegetable eaters, puree the vegetables and use them in sauces but always be sure to include the whole vegetable at a meal even if they only have a little bit.


 “Teach your child to eat in a rainbow.”


It is easy to say: “Have your child eat healthy.” but in reality we know that most children won’t eat everything put in front of them.  So until they are old enough to make good choices or until they are eating a well balanced diet: Supplement! Remember nutrition first then supplement.

Here is what I like to supplement my children with.  My children are offered fruits and vegetables throughout the day, but I know they do not get enough of them.  We are working on it.  Remember this is the bare minimum I recommend and some children will need more than what is on this list depending on their personal medical history:


  • Multivitamin

  • Vitamin D3

  • Omega-3 Fatty Acids


And in children who have been on antibiotics more than once in their life, are on an antacid or are continuing to get sick, I would consider putting that child on probiotics.

Why all of the above?  The multivitamin is to cover any vitamins and minerals your child may not be getting. Vitamin D because the majority of the world is insufficient or deficient and low levels can lead to recurrent viral illnesses.  An optimal Vitamin D level is 60 although most labs will report a normal level at 30.  You can also choose to allow for 20 minutes of sun exposure between the hours of 10 am and 2pm 3-4 times per week but this is difficult in the high temperatures of Doha.  You can test your child’s vitamin D levels.  However, this can be traumatic and it might be just as easy to supplement. Low omega 3 fatty acid levels have been associated with ADHD is a good for your child’s brain functioning and low levels have also been associated with ADHD.

There are other components to ensure your child’s wellbeing: adequate sleep, spiritual and emotional well being.  I will have to save these for another article.

So the next time, a story hits, don’t panic focus on prevention and nutrition first.

Many times I am asked: what vitamins would I recommend? I used to think that all vitamins are created equal.  However, they are not.  Sometimes the ingredients used in vitamins can do more damage then than the vitamin itself.  There are also excipients in many drugs, vitamins and supplements which can cause adverse reactions.  I am coordinating with several reputable professional grade vitamin and supplement companies so that you can have the option to purchase only quality products.  Here is a link to quality vitamins and supplements for your convenience.  Pure Encapsulations offers hypoallergenic supplements free of fillers, artificial flavors and excipients. They only ships within the USA. However as most expats have US forwarding addresses (with Aramex and the like), this should not pose a problem.


What came to mind for you when the story broke?  Do you have any tips for keeping your children healthy?


Photo credit: scragz



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  • Katya Barry

    Such an important message there, Rajka. Many parents think that their work is more important than their kids, please take a day off or work from home to make sure that you little one recovers quickly. Also  I agree that everyone should wash hand once entering the house not only before meals. Basic hygiene and fresh nutrition is so easy to do and takes no time at all but the benefits are tremendously huge.  

  • Expat Doctor Mom

     As always Katya, very insightful!  It is sad that nutrition is so downplayed and or the effects of good nutrition is minimized.  We are certainly learning a wide variety of diseases (not just diabetes) are a result of poor nutrition.

    Thanks so much for stopping by!

  • Jules44ca

    I was pregnant during the H1N1 pandemic in Canada. I was a virtual prisoner in my home for 3-4 months. I had to quit my job because I had to take public transit to work. I think the message here is simple. If you or your child is sick, stay home. We are talking about a day or two. It will pass. It is more than just being healthy. It is being a good neighbor, good employee and responsible parent.

  • Ken Grauer, MD

    In my recent travels to London (and a little while back to New York City) – I was struck by the observation that there seemed to be VERY FEW overly overweight people on the streets in those 2 cities (there are other such cities to be sure – but those are 2 that come to mind). The REASON: People walk a lot in those cities – a dramatic difference from much of the US. Regular exercise is a KEY component to being healthy.

    Final thought on Rajka’s excellent post on nutrition: I believe tastes (food preferences) can be influenced. Starting early by teaching a child to “eat in a rainbow” before bad eating habits become ingrained may help establish healthy habits that last a lifetime. THANKS Rajka for your column!

  • Bexy

    A great source of information (as always) thank you.  We as parents need educating on the values of good nutrition so we can pass these good habits onto our children.
    I would like to say I was advised to add vegetables before fruit when I was weaning my son as if you start them on the sweet fruits first they often don’t take well to vegetables…I definately found this to be true with my son who at almost 6 still loves his veggies!

  • PragmaticMom

    Good advice that good nutrition plays a huge role in keeping kids healthy! We need to work on the rainbow of veggies!

  • Christine Gerber Rutt

    At kindergarten in Switzerland the children were taught to cough and sneeze into the crook of their elbow to keep the yucks off their hands. 

    I like Katya’s suggestion. After reading this, I will try to find a way to politely ask the cleaning lady to wash her hands when she comes.

  • Expat Doctor Mom

     Thanks for your coments Katya.  Always appreciated!

  • Expat Doctor Mom

     Wow Julie!  Quit your job.  We had some seriously sick patients during that epidemic.  I was working outside of Seattle at the time.  Better to be cautious than sorry especially as the predictions were for a very bad epidemic.

  • Expat Doctor Mom

     All of us living in the desert are hit hard with the inability to walk during the day time hours: too hot!  Not to mention the lack of sidewalks here.  My kids both put on a couple pounds upon our return to Qatar after being outside everyday playing while in the USA.

    I also believe tastes can be influenced.  Still recalling the potato and chicken gizzard dish my parents ate (and we did too without complaint then!).  If I had to do it all again, I would never introduce juice and would stick to only the healthiest of processed snacks like rice cakes.  We have cleaned our pantry but there is still room for improvement!

  • Expat Doctor Mom

     Thanks Bexy for the compliments.
    Glad your son still likes his veggies! Keep up the good work!

  • Expat Doctor Mom

    I know us too on having the whole rainbow!

  • Expat Doctor Mom

     That is a great idea to have the kids cough into their elbows!  Thanks for sharing!

    I know, it is important to emphasize this with hired help especially if they are handling young children and or cooking food in the home.